Understanding acute invasive fungal rhinosinusitis for better treatment outcomes

Abstract

<p class="abstract"><strong>Background:</strong> Objectives of the study were to identify factors that affect patient survival, determine treatment outcomes in various clinical presentations, increase awareness amongst clinicians and provide more accurate treatment options to patients. Study design was a retrospective study. Study places were Tertiary care centre and a Medical College.</p><p class="abstract"><strong>Methods:</strong> A series of patients diagnosed and treated for acute invasive fungal rhinosinusitis over a period of 7 years. </p><p class="abstract"><strong>Results:</strong> Twelve patients were reviewed out of which eleven were diabetic. Most common fungus encountered was mucor. Six cases presented as sinonasal disease, four as rhino-orbital disease and two as rhino-orbito-cerebral disease. All the patients underwent surgical debridement with systemic antifungal treatment. It was seen that diseases confined to sino nasal areas had good prognosis. Early diagnosis and prompt intervention is major factor for better prognosis.</p><p class="abstract"><strong>Conclusions:</strong> Immunocompromised patients in ICU with ocular symptoms should be meticulously screened for invasive fungal rhinosinusitis. Early diagnosis and prompt management with surgical debridement and systemic antifungal treatment is utmost important factor in good prognosis. Intensivists and also the physicians should be made cognizant as they play important role in patient management as well. Multidisciplinary approach is the need of hour.</p>